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Q1. At what temperature a vaccine should be preserved?
A vaccine should be preserved between 2-8C. It should never be put in deep fridge or door of the refrigerator.

Q2. Once the container of the vaccine has been opened, for how long the vaccine can be used?
The reconstituted vaccine should never be used beyond two hours. Already prepared vaccine should be used with in the specified time mentioned on the vaccine. However a fresh sterilized needle should be used every time for withdrawing the vaccine from the container

Q3. What are the recommendations for spacing of multiple doses of the same vaccine?
There should be minimum of 4 to 6 wks interval between the administration of two doses of the same vaccine. However, it may be more depending upon the indications and type of vaccine.
Too frequent administration of some vaccines such as tetanus toxoid can result in increased rates of reactions.

Q4. At what interval the different vaccines can be administered?
As inactivated vaccines do not interfere with the immune response to other inactivated or live vaccines, so these can be administered along with other vaccines as per guidelines.
Live injectable vaccines such as MMR and VARICELLA are not administered at the same time or on the same day. At least there has to be 4 weeks interval between the administration of two live Injectable vaccines.

Q5. Do lapsed immunizations interfere with vaccine efficacy?
Longer than routinely recommended intervals between the doses of vaccine normally does not impair the immunologic response to live and inactivated vaccines. Resultantly interruptions of schedules and/or an extended lapse between booster doses do not need re-initiation of the entire immunization series.

Q6. What are the benefits offered by simultaneous vaccine administration?
Simultaneous administration of vaccines as per schedule decreases the number of visits and hence possibility of drop outs.

Q7. What are the factors that need to be remembered about the interchangeability of vaccines of different manufacturers?
Preferably the same brand should be used. However when not possible different brands can be used provided each vaccine is given according to the licensed recommendations.

Q8. What factors need to be considered for the site and route of immunization?
The preferred site in infants is anterolateral aspect of the thigh as it provides the largest muscle mass. In older children the deltoid muscle is the preferred site.
However there are vaccines which are administered at specific sites as per recommendations, such as Hepatitis B and Rabies vaccines.

Q9. What are the Contraindications and Precautions to immunization?
Live vaccines are contraindicated during pregnancy and immunosuppression.
Vaccination should be withheld during moderate or severe acute illness.
However mild fever, cough and cold are not the contraindications for any vaccination.

Q10. Can child be given breast feed after the oral polio dose?
Yes. Contrary to the popular belief breast feeding does not interfere with successful immunization with OPV vaccine.

Q11. Can one give oral vaccines during the period of recurrent vomiting and diarrhoea?
NO. Oral vaccines should be administered only when one is cured of vomiting and diarrhoea.

Q12. What should be done if the child vomits after the ingestion of oral polio?
The vaccine has to be given again and antiemetic drugs may be used, if required.

Q13. If BCG permanent mark is not formed after 6-8 weeks of giving BCG, should BCG vaccination be repeated?

Q14. Which one of the pertussis vaccines, acellular (DTaP) or whole cell (DTwP) vaccine should be used?
Both of them are highly effective with almost 80-90% clinical efficacy. Acellular vaccine may be preferable for booster immunization.

Q15. How long we should withhold routine OPV (tOPV-Trivalent) when Pulse Polio dose of mOPV (monovalent OPV) is administered?
It is advisable to withhold tOPV for atleast a week after mOPV as different strains of OPV slightly interferes with one another.

Q16. Do we need the second dose of the MMR and Chicken Pox vaccine?
With extensive mass coverage of the population with MMR and Chicken Pox vaccines, the chances of getting sub clinical re infections of measles, mumps, rubella and chicken pox are rare. Thus, there is a tendency of decline in the antibodies titers against these infections after a certain time (10-15 years). Thus a booster dose around 5-7 years after the first dose of MMR or chicken pox is being advised to shoot up the effective immunity for the whole life.

Q17. Does the vaccination against Chicken Pox helps in the prevention of Herpes Zoster?

Q18. What about the immunization of the child who have recovered from Diphtheria, Pertussis or Tetanus?
Diphtheria and Tetanus do not confer long term immunity. Therefore, active immunization should be undertaken against them after recovery from illness or during convalescence. Children who have recovered from confirmed Pertussis do not need Pertussis vaccine. But if any such confirmation is lacking, DTP vaccination should be completed as per schedule.

Q19. Should Typhoid vaccine be given after recovery from Typhoid illness?
Yes, as early as possible. Typhoid illness does not impart any long term immunity. Hence vaccination is strongly recommended especially in endemic areas and for travelers to endemic areas.

Q20. Are there any problems with available Combo Vaccines?
Available combo vaccines, which have been duly approved by Drug Control Authority, are safe. However one should never mix two or more vaccines just to avoid multiple injections.

Q21. What are the immunoglobulins that are commonly available against common diseases in the market for passive immunization?
  • TIG- Tetanus Immunoglobulin
  • DIG- Diphtheria Immunoglobulin
  • Immunoglobulin against Pertussis
  • RIG- Rabies Immunoglobulin
  • HBIG – Hepatitis B Immunoglobulin
  • IgM and IgG for general use.
  • Varicella Zoster Immunoglobulin (VZIG)
For further information on the use of above mentioned immune globulins, please refer to write up on passive immunization or specific diseases.
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